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Valsalva Maneuver

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181. Long-term Outcomes of Balloon Dilation for Persistent Eustachian Tube Dysfunction. (Abstract)

was observed by 93.6% (44/47) participants. The revision dilation rate was 2.1% (1/47). Among participants with abnormal baseline middle ear assessments, 76.0% had normalized tympanic membrane position (p < 0.0001), 62.5% had normalization of tympanogram type (p < 0.001), and 66.7% had positive Valsalva maneuvers (p < 0.0001). Participant satisfaction was 83.0% at long-term follow-up.Balloon dilation results in durable improvements in symptoms and middle ear assessments for patients with persistent

2019 Otology and Neurotology Controlled trial quality: uncertain

182. Vagal and Sympathetic Function in Neuropathic Postural Tachycardia Syndrome. Full Text available with Trip Pro

. We compared them to 10 healthy subjects. We assessed hemodynamics, heart rate and blood pressure variability, baroreflex sensitivity, raw and integrated muscle sympathetic nerve activity, and blood volume. To understand the vagal/sympathetic control, we dissected the phase 2 of Valsalva maneuver (VM) into early (VM2e) and late (VM2l). POTS' upright heart rate increased 43±3 bpm. Patients had normal plasma volume but reduced red blood cell volume (1.29 L versus predicted normal values 1.58 L; P

2019 Hypertension

183. Effort Thrombosis Provoked by Saxophone Performance. (Abstract)

effort thrombosis of the internal jugular vein. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: To our knowledge, this is the first documented case of PSS resulting from venous stasis with prolonged Valsalva maneuver and vascular trauma with activity of playing the saxophone. The significance of this case is the unusual etiology of a rare presentation and the ability to diagnose this condition quickly and accurately with POCUS.Copyright © 2018 Elsevier Inc. All rights reserved.

2019 Journal of Emergency Medicine

184. Effects of full-fat dairy products on subclinical vascular function in adults with elevated blood pressure: a randomized clinical trial. (Abstract)

(cfPWV) did not differ significantly between high dairy (11.3 ± 0.3 versus 10.9 ± 0.3 m/sec) and no dairy conditions (11.2 ± 0.3 versus 11.0 ± 0.3 m/sec). The results were consistent when ultrasound-derived vascular distension measures (arterial compliance, beta-stiffness index, and elastic modulus) were evaluated. Cardiovagal baroreceptor sensitivity (via Valsalva maneuver) demonstrated no significant difference for either dietary condition. Brachial arterial flow-mediated dilation (FMD) did

2019 European journal of clinical nutrition Controlled trial quality: uncertain

185. Sensitivity of contrast-enhanced transthoracic echocardiography for the detection of residual shunts after percutaneous patent foramen ovale closure. Full Text available with Trip Pro

patients with PFO who had experienced migraines underwent percutaneous PFO closure. c-TTE, TEE, and contrast-enhanced transcranial Doppler (c-TCD) at resting and Valsalva maneuver were performed during the 3-month follow-up after the closure.The closure devices were successfully implanted in all patients without complications. Three months after closure, TEE did not detect residual Valsalva shunts in any of the 57 patients; residual valsalva shunts were found via c-TTE in 15 of the 57 patients and were

2019 Medicine

186. Effects of different respiratory maneuvers on esophageal sphincters in obese patients before and during anesthesia. (Abstract)

Effects of different respiratory maneuvers on esophageal sphincters in obese patients before and during anesthesia. Data on esophageal sphincters in obese individuals during anesthesia are sparse. The aim of the present study was to evaluate the effects of different respiratory maneuvers on the pressures in the esophagus and esophageal sphincters before and during anesthesia in obese patients.Seventeen patients, aged 28-68 years, with a BMI ≥ 35 kg/m², who were undergoing a laparoscopic gastric (...) by-pass surgery, were studied, and pressures from the hypopharynx to the stomach were recorded using high-resolution solid-state manometry. Before anesthesia, recordings were performed during normal spontaneous breathing, Valsalva and forced inspiration. The effects of anesthesia induction with remifentanil and propofol were evaluated, and positive end-expiratory pressure (PEEP) 10 cmH₂O was applied during anesthesia.During spontaneous breathing, the lower esophageal sphincter (LES) pressure

2010 Acta Anaesthesiologica Scandinavica

188. Breathlessness

"painless" heart attacks recommends that standard guidelines should be followed in the management of people with painless myocardial infarction [ ]. Management of supraventricular tachycardia (SVT) Recommendations are based on a Cochrane Review on the use of the Valsalva Maneuver in SVT [ ] and expert opinion published in the Oxford handbook of General Practice [ ]. the Oxford textbook of medicine [ ] and guidelines published by the Resuscitation Council (UK) [ ]. Management of acute asthma (...) of hypercapnia; or critically ill Identify and treat people with clinical features of: : give aspirin 300 mg. . Give an intravenous diuretic, opioid, and anti-emetic (for example furosemide 20 mg to 50 mg slowly, diamorphine 2.5 mg to 5.0 mg slowly (over 5 minutes), and metoclopramide 10 mg). Also give glyceryl trinitrate [GTN] spray, two puffs sublingually. (SVT). Attempt to terminate the arrhythmia, using a valsalva manoeuvre or carotid sinus massage. For further information, see the CKS topic

2017 NICE Clinical Knowledge Summaries

189. Effects of aerobic or resistance exercise training on cardiovascular autonomic function of subjects with type 2 diabetes: A pilot study. (Abstract)

during a standardized Valsalva maneuver using two indexes, b2 and b4, considered an expression of baroreceptor sensitivity and peripheral vasoactive adaptations during predominant sympathetic and parasympathetic drive, respectively. After training, the LF/HF ratio, which summarizes the sympatho-vagal balance in HRV control, was similarly decreased in the AER and RES groups. After AER, b2 and b4 significantly improved. After RES, changes of b2 were of borderline significance, whereas changes of b4 did

2018 Nutrition, metabolism, and cardiovascular diseases : NMCD Controlled trial quality: uncertain

190. [Microscopic spermatic vein ligation for the treatment of varicocele]. (Abstract)

groups of patients in the internal diameters of the spermatic vein during eupnea and Valsalva maneuver, the reflux time of the spermatic vein, blood flow parameters of the testicular artery, and semen quality before and at 3 months after surgery.At 3 months after surgery, the experimental group, as compared with the control, showed significantly decreased reflux time of the spermatic vein ([0.41 ± 0.10] vs [1.08 ± 0.10] s, P <0.05) and peak systolic velocity (9.26 ± 1.35 vs 10.64 ± 1.28, P <0.05 (...) ) and resistance index (0.52 ± 0.03 vs 0.61 ± 0.03, P <0.05) of the testicular artery but markedly increased internal diameters of the spermatic vein during eupnea ([1.63 ± 0.07] vs [1.59 ± 0.06] mm, P <0.05) and Valsalva maneuver ([1.72 ± 0.05] vs [1.68 ± 0.07] mm, P <0.05), sperm concentration ([46.84 ± 5.24] vs [35.35 ± 4.26] ×10⁶/ml, P <0.05), sperm motility ([63.75 ± 7.73] vs [53.87 ± 6.46] %, P <0.05), and total sperm count ([89.54 ± 7.95] vs [75.24 ± 8.43] ×10⁶/ml, P <0.05).Microscopic spermatic vein

2018 Zhonghua nan ke xue = National journal of andrology Controlled trial quality: uncertain

191. Structural changes in puborectalis muscle after vaginal delivery. Full Text available with Trip Pro

Structural changes in puborectalis muscle after vaginal delivery. To evaluate the structural composition of the puborectalis muscle before and at several timepoints after first vaginal delivery, by the use of echogenicity and area measurements, in order to explore its recovery.Twenty nulliparous women with a singleton pregnancy underwent 3D/4D transperineal ultrasound assessments at rest, on pelvic floor muscle contraction and on Valsalva maneuver at 12 weeks' gestation and at 1 day and 1, 2, 3 (...)  weeks after delivery. Although not statistically significant, a decrease in MEP was observed between 3 and 4 weeks after delivery for all maneuvers. PMA at rest and on Valsalva maneuver remained constant after delivery.When compared with measurements taken during pregnancy, a sharp decrease in MEP was observed soon after vaginal delivery, which was most likely caused by stretch trauma to the puborectalis muscle and subsequent formation of (micro) hematoma and edema. Subsequent increases in MEP may

2018 Ultrasound in Obstetrics and Gynecology

192. Effect of Patent Foramen Ovale in Patients With Pulmonary Hypertension. (Abstract)

and if negative repeatinjection after Valsalva maneuver. Echocardiographic and hemodynamic data were examined. Survival was modeled using Kaplan-Meier method. Eisenmenger syndrome or known atrial shunts other than PFO were excluded: 292 patients met entry criteria. A PFO was identified in 16.8% of the entire cohort, 22.9% of pulmonary arterial hypertension (PAH) patients, and 8.6% of Dana Point group 2 PH patients. Right atrial to pulmonary capillary wedge pressure difference was lowest in the latter group (...) to inability of Valsalva maneuver to overcome right atrial to pulmonary capillary wedge pressure difference. In conclusion, the incidence of a PFO in the PH population increases with more dilated and dysfunctional RVs, suggesting that the PFO may be stretched open rather than congenital. The presence of a PFO does not impact survival in PH or PAH.Copyright © 2018. Published by Elsevier Inc.

2018 American Journal of Cardiology

193. Management of Supraventricular Tachycardia of Children

about in all cases: Clinical examination and ECG at presentation,Physical maneuvers(vagal stimulation),Drug therapy including:adenosine and other antiarrythmic drugs as Flecainide,propranolol,amiodarone,digoxin and verapamil. Appropriate dose of drugs,Putting on monitor ECG during treatment,Synchronized DC cardioversion in hemodynamically unstable cases. Yes ,No ,℅ of the folowing, Clinical examination and ECG at presentation Vagal manoeuvers,diving reflex,One side carotid massage,Valsalva manoeuvre

2018 Clinical Trials

194. Clinical Study to Evaluate Mavacamten (MYK-461) in Adults With Symptomatic Obstructive Hypertrophic Cardiomyopathy

to perform an upright CPET and has a respiratory exchange ratio (RER) ≥1.0 at Screening per central reading LVOT gradient with Valsalva maneuver >=30 mmHg at Screening determined by echocardiography core lab Key Exclusion Criteria: Known infiltrative or storage disorder causing cardiac hypertrophy that mimics oHCM, such as Fabry disease, amyloidosis, or Noonan syndrome with LV hypertrophy History of syncope or sustained ventricular tachyarrhythmia with exercise within 6 months prior to Screening History (...) prior to Screening) or planned treatment during the study with disopyramide or ranolazine Treatment (within 14 days prior to Screening) or planned treatment during the study with a combination of β-blockers and calcium channel blockers LVOT gradient with Valsalva maneuver <30 mmHg at Screening Has been successfully treated with invasive septal reduction (surgical myectomy or percutaneous alcohol septal ablation [ASA]) within 6 months prior to Screening or plans to have either of these treatments

2018 Clinical Trials

195. Assessment and Comparison of Biomarkers in Women With Symptoms of Overactive Bladder (OAB) and Pelvic Organ Prolapse (POP)

will be assessed through the following questionnaires: (a) ICIQ-OAB (b) ICIQ FLUTS (c) ICIQ-VS. Determination of the bladder neck of urethra in midsagittal plane using a transvaginal two-dimensional ultrasound machine at lithotomy position in rest (point OA) and on Valsalva maneuver (point OB). Bladder Neck Mobility is defined as the difference from point OA to OB. BWT is determined and measured as the hypoechoic layer between two hyperechoic layers that is recognized as the urothelium and the perivesical (...) a transvaginal two-dimensional ultrasound machine at lithotomy position in rest (point OA) and on Valsalva maneuver (point OB). Bladder Neck Mobility is defined as the difference from point OA to OB. BWT is determined and measured as the hypoechoic layer between two hyperechoic layers that is recognized as the urothelium and the perivesical tissue using a transvaginal two-dimensional ultrasound machine at lithotomy position. The measurement is performed with a bladder volume <30 ml and is taken place in 3

2018 Clinical Trials

196. The Effect of Metoprolol in Patients With Hypertrophic Obstructive Cardiomyopathy.

at rest and/or > 50 mmHg at Valsalva's maneuver or exercise New York Heart Association Functional class (NYHA) ≥ II Exclusion Criteria: Age < 18 years Known allergy to trial medicine Contraindications to beta-blocker treatment Contraindications to Magnetic resonans scan, including contraindication to the contrast agent gadolinium. Female patients who are pregnant (positive plasma-HCG), breastfeeding or of child-bearing potential while not practicing effective chemical contraceptive hormones. In case

2018 Clinical Trials

197. Forceps vs Vacuum. Rate of Levator Ani Muscle Avulsion: Clinical Trial.

perineum, applying the minimal possible pressure. Three volume measurements were taken for each patient: at rest, with Valsalva maneuver and with maximum contraction. Then, offline analysis of ultrasound volumes was carried out. Analysis of ultrasound volumes was performed offline. In the multi-view ultrasound images, complete avulsion was defined as an abnormal insertion of LAM in the lower pubic branch identified in all three central slices, i.e. in the plane of minimal hiatal dimensions (PMD (...) /cm2 ). Traction was carried out during contraction, along with maternal push, at a rate of 2-3 tractions per contraction, and without associating Kristeller maneuver. The procedure was abandoned if, after three cup slides or 15 min, fetal extraction had not been successful. Selective episiotomy was carried out in VD following Valme's University Hospital clinical practice guideline for instrumental deliveries. Obstetric parameters evaluated were: gestational age, labor induction, epidural analgesia

2018 Clinical Trials

198. Data Collection

Sample Study Population Patients that have previously undergone a ARS assessment and were diagnosed with OH or reflex syncope, or are control subjects. Criteria Inclusion Criteria: Willing and capable to provide informed consent Age 18 or above No contraindications to undergo tilt table test, Valsalva maneuver test, and deep breathing test (Components of the ARS assessment) Previously underwent a clinically indicated ARS assessment without complications (including deep breathing, Valsalva maneuver (...) , and tilt table testing). Previously diagnosed with OH, reflex syncope, OR control subjects assessed as normal, based on the ARS assessment. Patient enrollment shall be based on the type of diagnosis. Willing to participate in one additional tilt table test, Valsalva maneuver test, and deep breathing test (components of the ARS assessment) Exclusion Criteria: Currently enrolled in another clinical trial that might interfere with data collection. Subject is pregnant or planning to become pregnant during

2018 Clinical Trials

199. Multidisciplinary Treatment of Chronic Vulvar Pain

hiatal area (cm^2) between rest and contraction and between rest and valsalva maneuver Levator hiatal area [ Time Frame: Baseline, 6 months and 12 months (change) ] Ultrasound-measured difference in levator hiatal area (cm^2) between rest and contraction and between rest and valsalva maneuver Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about

2018 Clinical Trials

200. Ertugliflozin Versus Hydrochlorothiazide in Reducing Sympathetic Neural Overactivity in Patients With Hypertension and Recently-diagnosed Type 2 Diabetes.

in arterial pressure induced by the Valsalva maneuver. The aim of this protocol is to determine if the sympathetic nerve, as well as the heart rate, component of the sinoaortic baroreflex can be augmented by the SGLT2 inhibitor. After obtaining stable baseline recordings, arterial pressure, heart rate, and muscle sympathetic nerve activity will recorded during spontaneous fluctuations in BP over 5 minutes and during both decreases in BP during phase III of the Valsavla maneuver and during the phase IV (...) fluctuations in arterial pressure and during decreases and increases in arterial pressure induced by the Valsalva maneuver. The aim of this protocol is to determine if the sympathetic nerve, as well as the heart rate, component of the sinoaortic baroreflex can be augmented by the SGLT2 inhibitor. After obtaining stable baseline recordings, arterial pressure, heart rate, and muscle sympathetic nerve activity will recorded during spontaneous fluctuations in BP over 5 minutes and during both decreases in BP

2018 Clinical Trials

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